Abstract 197: Racial Disparity In Major Adverse Cardiovascular Events In Patients With History Of Inflammatory Bowel Disease: Analysis From The National Inpatient Sample

Objective: We aimed to uncover gender and racial differences in major adverse cardiovascular events (MACE) in patients with inflammatory bowel disease (IBD).

Methods: The National Inpatient Sample was retrospectively studied (1/1/19-12/31/19) for IBD hospitalizations of ages >17 years. The primary outcome was a composite 5 point-MACE: cerebrovascular accident (CVA), myocardial infarction (STEMI and NSTEMI), congestive heart failure (CHF), Hypertension (HTN), and peripheral arterial disease (PAD). Type of coronary revascularization was assessed: percutaneous intervention (PCI) or coronary artery bypass graft (CABG). Data were analyzed in STATA 16.0, and adjusted odds ratios (AOR) were calculated using hierarchal multivariate regression analysis reported with 95% confidence interval (CI) and P-values.

Results: The study included 169,355 patients (females=78705). Caucasians were the predominant race ([78%] reference) followed by African Americans (AA) (11%), Hispanics (H) (7%), and others (4%). Analyses revealed decreased association of STEMI (AOR 0.56, [0.35-0.90], P < 0.001), NSTEMI (AOR 0.53, [0.31-0.92], P < 0.001), CABG (AOR 0.12, [0.01-0.90], P < 0.001) and PAD (AOR 0.76, [0.65-0.89], P < 0.001) in AA vs Caucasians. Concurrently, there was an increased association of CHF (AOR 1.63, [1.43 -1.86], P < 0.001) and HTN (AOR 2.1, [1.88-2.24], P < 0.001) in the AA cohort. No significant difference existed between Hispanics and Caucasians for risk of MACE. Subgroup analysis for ulcerative colitis revealed a decreased occurrence of CABG (P < 0.001) and an increased association of HTN, PAD, and CHF in AA cohort (P < 0.001). Subgroup analysis for Crohn’s disease revealed an increased association between HTN and CHF in AA vs Caucasians (P < 0.001). Subgroup analysis for females revealed a decreased association of STEMI and NSTEMI in AA cohort (P< 0.001) and an increased association of HTN, PAD, and CHF (P < 0.001) compared to Caucasians.

Conclusion: African American patients with IBD are more likely to develop HTN, PAD, and CHF compared to their Caucasian counterparts while the occurrence of STEMI, NSTEMI, and CABG is reduced. There was no statistically significant change noted in outcomes in the Hispanic population.